螺旋CT与磁共振成像对早期强直性脊柱炎骶髂关节病变的诊断比较研究

A comparative study of spiral CT and magnetic resonance imaging in the diagnosis of sacroiliac joint lesions of early ankylosing spondylitis

目的比较螺旋CT与磁共振成像(MRI)对早期强直性脊柱炎骶髂关节病变中的临床诊断价值。方法选择医院2015年10月~2017年12月收治的强直性脊柱炎骶髂关节病变患者50例,对所有患者均实施早期CT检查和MRI检查,比较CT和MRI诊断早期强直性脊柱炎骶髂关节病变的分级情况及骨质异常检出情况。结果MRI对0级、II级、III级及IV级强直性脊柱炎骶髂关节病变的诊断检出率与螺旋CT无显著差异,MRI对I级强直性脊柱炎骶髂关节病变的检出率显著高于螺旋CT,差异有统计学意义(P<0.05)。MRI对关节骨质侵蚀、关节面下骨质囊变、腰5骶1关节病变、软组织肿胀等部位病变检出率显著高于螺旋CT,差异有统计学意义(P<0.05)。结论 MRI对早期强直性脊柱炎骶髂关节病变的诊断优于螺旋CT,可明显诊断出关节骨质侵蚀、关节面下骨质囊变、腰5骶1关节病变、软组织肿胀等病变。

Objective To compare the clinical diagnostic value of spiral CT and magnetic resonance imaging（ MRI） in the sacroiliac joint lesions of early ankylosing spondylitis. Methods 50 sacroiliac joints in ankylosing spondylitis patients admitted to hospital in October 2015 ~ 2017 year in December,the implementation of both early CT examination and MRI examination in all patients,CT and MRI in early diagnosis of sacroiliac joint in ankylosing spondylitis classification and detection of abnormal bone. Results There was no significant difference in the diagnostic rate of MRI for sacroiliac joint lesions of grade 0,II,III and IV ankylosing spondylitis,and that of spiral CT. The detection rate of MRI for I grade ankylosing spondylitis and sacroiliac joint lesions was significantly higher than that of spiral CT,and the difference was statistically significant（ P 〈 0. 05）. The detection rate of MRI was significantly higher than that of spiral CT in joint bone erosion,articular surface bone cyst change,lumbar 5 sacral 1 joint disease and soft tissue swelling,and the difference was statistically significant（ P 〈 0. 05）. Conclusion MRI is superior to spiral CT in the diagnosis of ankylosing spondylitis and sacroiliac joint lesions in early stage. It can clearly diagnose joint bone erosion,articular surface bone cyst changes,lumbar 5 sacral 1 joint lesions,soft tissue swelling and other lesions.